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Shoulder pain – the Swimmer’s Bane

When I started swimming OW long distance, my first long distance swim was Clew Bay, a 12km in the West Of Ireland.
(Boat drop onto an island out in the bay, guided swim into Newport Town, through the islands…you’d get lost without a boat guide).

A week later I started to have shoulder soreness, especially at night, while sleeping on the shoulder.

It dragged on for months gradually getting worse. I took an extended rest, but it didn’t do the trick. Visited a Doctor and Physiotherapist before finally visiting a sports masseur, and getting it sorted.

Rotator Cuff Impingement, aka ” shoulder problem”.

This is a problem for all swimmers but long distance swimmers in particular.

There is a lot of information from various sources about this, but not all of it useful…

The cause –
Constant movement of the arm over the head can cause inflammation on the rotator cuff tendons from movement over the shoulder. It’s typical to swimmers, tennis-layers and apparently baseball players.

The symptoms –
The problem typically expresses itself by pain, soreness or tenderness in the posterior deltoid, i.e. the soreness is at the bottom of the deltoid, where it connects with the upper arm and feels like it’s around the bicep area 6 or 7 inches down the arm.
You may also have pain at night particularly while lying on the arm.
You’ll probably feel fine while swimming. It may be adduction or abduction, i.e if someone provides contrary pressure to you arm while pressing outwards (abduction) or pulling in and across (adduction).
You can take a break for a week or two, thinks it’s gone, but it comes back. Anti-inflammatories help but again the problem comes back.

So you’ve already got it. What do you do?

Physiotherapists will give you various exercises, to strengthen the underused muscles, the external rotator, which helps balance the shoulders. My experience was this was a very slow and not very effective remedy, as I still had the problem.
Visiting a Sports Masseuse though, had a big impact. One weekly massage for a few weeks COMBINED with regular icing of the area. I was able to keep swimming and the problem has never returned seriously. If it flares up, I just start icing for a few days in the morning and night for abut 5 minutes per shoulder, occasionally using “Deep Cold” gel also.

The mistake I made, and which I see repeated all the time, is to increase the mileage too quickly.
USMS, the American College of Sports Medicine etc, recommend a weekly mileage increase of no-more than 5% per week.

In my case for the Channel, I’ve been building up mileage for 3 years. Sure you could do the training in a year, but the risk run of recurring shoulder problems would be far higher.

One further thing. I said all swimmers above. I regularly meet people with the problem who are are recreational swimmers, doing 800 or 1000 metres 3 or 4 times a week. But once they have the problem they think heat and swimming makes it feel better, so they can have it for a long time. I met one guy last year who’d had the problem over a year, after swimming about 500 metres continuously one day on his holidays in warm water. Two visits to a sports masseuse and he was sorted.

In the meantime, make sure you are either doing your externalrotatorcuff exercises or adding backstroke into your sessions (each word is a different link).